The Business of Being Born

[spacefem]

Most of you know I had a baby recently, and while I was pregnant I purposefully avoided watching this documentary because I was afraid it'd scare the crap out of me. And it might have. But it's still worth checking out.

The Business of Being Born explores childbirth in America, where most babies are born in hospitals with doctors and the rates of cesarean section keep increasing. Most of the views expressed are those of homebirth proponents and midwives, who pose questions about why so many medical procedures have become routine when most births don't really need a ton of interventions. The film sort of divides labor and delivery into two categories:

- Hospital birth. It's done on a doctor's time clock. If things aren't progressing well you're given drugs to make contractions stronger (pitocin), driving up the need for pain medication, which slows down labor even more, which means more pitocin, but eventually these very strong artificially enhanced contractions put stress on the baby and it has to come out NOW which means they either reach for the forcepts (and you need to be cut for those to fit) or send you in for a c-section.

- Homebirth. A circle of empowered women and educated midwives encourage you up the steep mountain that is labor & delivery. It's painful, and it's a lot of work, but it's what your body was made to do and when you're done you will feel accomplished and lucky to have "experienced" childbirth in all its power and glory.

The film dispels some myths about midwives ("they don't just show up with a stick to bite down on") and looks at the history of doctors... really, it seems like hospital birth got popular because doctors wanted to make money, and insurance companies supported them because nobody ever trusted women to do this in the first place. And I think it's valid to ask those questions.

Based on my own experience though I don't think hospital birth is quite as scary as they make it sound. I had a natural childbirth in a hospital, and everyone from the nurses to the anesthesiologist (who I dismissed) were supportive and encouraging of my decision. No one took advantage of my altered state to intervene in unnecessary ways, I wasn't asked to lay flat on my back with my feet in stirrups. And there were some advantages... if I needed a c-section (and sometimes they are needed) I was only a short cartride away from surgery. There was a whole staff of nurses to help me during labor and recovery. Everything was clean and ready to go when I arrived.

It should be noted though that my mother's experience having me in 1980 was very different, and when she had time to look around at my hospital room she said that my experience was the result of a lot of women fighting for a lot of years. I gave birth in a suite. The baby stayed right in the room with us the whole time. There was a bathtub with water jets for comfort during labor, a foldout couch so my husband could stay the night, a little side room for family to hang out in. Progress has only been made because people asked questions.

So that's why I'm glad this documentary was made... it asks questions. If you ever plan to give birth or be around for one, go ahead and watch the film, and talk to people too. I wanted a natural birth because I'd heard so many positive experiences from friends and family, and I felt comfortable with my decision to use a hospital because I reviewed its policies ahead of time, talked with staff, toured the birth center and had friends who'd used the same place. I definitely agree that more medical intervention is not always better, and childbirth needs to be seen as a normal, healthy event. And that women need to be in control.

I give it four houses:

[monk]

So that's why I'm glad this documentary was made... it asks questions. If you ever plan to give birth or be around for one, go ahead and watch the film, and talk to people too. I wanted a natural birth because I'd heard so many positive experiences from friends and family, and I felt comfortable with my decision to use a hospital because I reviewed its policies ahead of time, talked with staff, toured the birth center and had friends who'd used the same place. I definitely agree that more medical intervention is not always better, and childbirth needs to be seen as a normal, healthy event. And that women need to be in control.

I was right there with you till that last sentence. Women don't need to be in control. That the woman having the baby should educate herself in advance about her options is not in doubt but she has the right to give up power and control over the actual birth process if that's what she wants. I know a woman(my ex sister in Law) who has had seven kids (all but 1 with a C-section) and she basically is letting the doctor run the show (her doctors have been both male a female) and she likes the fact that her only job is to grow the baby and when the time comes she goes to the hospital takes a happy pill and wakes up one child richer. Then again, you may be right, my ex sister in law is nut for wanting seven kids in the first place.

[AdAstra]

I'd wager that a big part of the reason hospital births today are different from those 30+ years ago is due in large part to the increase in women doctors and hospital administrators.

Admittedly, I'm biased because my mother is a doctor (though not an OB/GYN), but claiming that the prevalence of hospital births over midwives is because doctors want to make money seems like a slap in the face to modern medicine, both in standards and technology. I know that's what the film asserts, not you personally.

While questioning reliance on hospitals for childbirth and most everything else is valid, it's also nice to know that they're an option. I guess, for me, it all comes down to having that choice and educating yourself enough to know what your options are. If a woman chooses to have a midwife's assistance only, natural childbirth in a hospital setting, or schedule a C-section in advance then do be it.

Venturing too close to another woman's uterus is a slippery slope to other reproductive rights issues

[Aum]

spacefem, thanks for the movie title, I downloaded it and watched it tonight. Such an interesting documentary. To a lot of people watching it, it would seem slanted towards favoring midwifery, but I don't think it's that way at all. When you assess the c-section rate in the U.S. compared to all other western nations in combination with the infant mortality rate, there is clearly something strange going on. The facts are undeniable, so if there is any apparent slant, it is based in real information and not simple opinion.

Something like 2% of childbirths have genuine complications requiring intervention and midwives are trained to investigate and make immediate decisions. For all the other women, the woman's body knows what to do and the woman just needs passive support during the process. I've also heard a lot of arguments against midwifery, but as the film demonstrates, most of the MDs who speak out against it have never even witnessed a normal vaginal birth and are simply trained by the establishment to work against vaginal delivery in a lot of cases. They are being taught something that does not have a basis in sound medical science.

Hospitals are a business before they are centres of healing. Even a doctor in the film said that. They are places you go for emergency situations. For everything else, I think it's best to stay well away from them, and I say that with every other kind of illness in mind. A piece of info. in the movie that I also heard prior to watching it is that the U.S. has the most expensive child birthing process in the world, yet demonstrates the highest infant mortality rate.

Definitely gave me a lot to think about, even as a guy. Thanks for dropping the title name.

[Butterfly North]

I was reading a very interesting article in the Times recently about why the international target rate set for c-sections of about 15% had been dropped because it wasn't based on evidence and was as such mostly arbitrary. Some of those countries with the lowest infant mortality rates have c-section rates around 30%. Unfortunately the Times has just started charging users for its online content so I can't get to the article.

But the situation as described by it in Britain is basically: women could be dying because of health professionals' reluctance to advice a c-section in order to keep their number down and so adhere to the target. There was a recent news story concerning a woman who was in labour for three days before being told she needed a c-section for her baby to live, and while being wheeled into the operation a nurse started shouting at her, something along the lines of 'Why can't women just give birth naturally for God's sake!?' Yet despite this attitude c-sections are on the rise. The article cites the rising age of those giving birth, along with increased obesity, as factors as to why more people need Caesareans.

Now, I have no idea if this was biased or not. I think though it's certainly important to remember that the number of medical interventions into births should be entirely based on the number of women and babies who need those interventions. Since there is no reliable data on how many will need c-sections (and this figure is liable to change based on lifestyle changes) we shouldn't be deciding against them based on some arbitrary target any more than we should be opting for them for reasons of profit.

[kelsa]

So that's why I'm glad this documentary was made... it asks questions. If you ever plan to give birth or be around for one, go ahead and watch the film, and talk to people too. I wanted a natural birth because I'd heard so many positive experiences from friends and family, and I felt comfortable with my decision to use a hospital because I reviewed its policies ahead of time, talked with staff, toured the birth center and had friends who'd used the same place. I definitely agree that more medical intervention is not always better, and childbirth needs to be seen as a normal, healthy event. And that women need to be in control.

I was right there with you till that last sentence. Women don't need to be in control. That the woman having the baby should educate herself in advance about her options is not in doubt but she has the right to give up power and control over the actual birth process if that's what she wants. I know a woman(my ex sister in Law) who has had seven kids (all but 1 with a C-section) and she basically is letting the doctor run the show (her doctors have been both male a female) and she likes the fact that her only job is to grow the baby and when the time comes she goes to the hospital takes a happy pill and wakes up one child richer. Then again, you may be right, my ex sister in law is nut for wanting seven kids in the first place.

You do realize your ex sister in law was still in control over her situation? She chose what option was best for her and that is control, and she can change her approach, if she wishes to, in her next labor because no one is forcing her to have her child in one particular manner. Cute anecdote, don't know why it was relevant, and no one called your relative a nut for wanting any amount of kids.

[monk]

You do realize your ex sister in law was still in control over her situation? She chose what option was best for her and that is control, and she can change her approach, if she wishes to, in her next labor because no one is forcing her to have her child in one particular manner.

She chose to give up control and leave the decision about her situation to someone else. I am just saying that it's not necessary for her have control if she doesn't want it and on that same note, if a doctor says, "this baby is in extreme danger if you don't have a c-section" but the woman insists on doing it naturally what happens, who knows more about it, the mom or the baby doctor?

Cute anecdote, don't know why it was relevant, and no one called your relative a nut for wanting any amount of kids.

I called her a nut, why? because the first two kids were with guy A, the second three were with guy B, and the last two were with Guy A again and that's not even going into the lack of finances to support the kids properly and the obsession with all things NASCAR.

[Neko]

You do realize your ex sister in law was still in control over her situation? She chose what option was best for her and that is control, and she can change her approach, if she wishes to, in her next labor because no one is forcing her to have her child in one particular manner.

She chose to give up control and leave the decision about her situation to someone else. I am just saying that it's not necessary for her have control if she doesn't want it and on that same note, if a doctor says, "this baby is in extreme danger if you don't have a c-section" but the woman insists on doing it naturally what happens, who knows more about it, the mom or the baby doctor?

I think kelsa's point is what is in bold here.

[CTM]

i had a friend who was bullied into have her son by c-section 5 weeks early. the doctor told her she had prego-diabetes (which she did, mildly) and used his experience and authority to convince her that if she didn't get the child out as soon as possible, he would die. she found out later that this was all bullshit, but it brings up two interesting points. First, she would have had more power here if she had trusted and questioned a little more (and then maybe her kid wouldn't have been a zombie for the first month of his life). Secondly, this is a problem that is growing in America, but OUT OF CONTROL in other regions with less oversight of doctors (all this went down in Mexico). Turns out the doctors in this city all want to do c-sections because of course they cost more than natural births; however, demand has outstripped OR supply and so they are pushing women to give birth when an opening is available (five weeks early!), not when the kid is ready. Lessons I learned from this: learn as much as you can, question as much as you feel necessary, even if you piss off the staff, and don't try to push one out in Mexico!!!!

[CTM]

and thanks for bringing this up!!!!